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Register for the Bosom Buddies Breastfeeding Support Group HERE by sending me an email letting me know when you will be attending for the first time.

You are welcome to join the Breastfeeding Support Group, Bosom Buddies; we try meet every Wednesday from 11-12:30 pm at the Community Center Room on the first floor of the Colts Neck Library,1 Winthrop Lane, Colts Neck, NJ.

The group is FREE and open to all breastfeeding mothers and babies. This is a mother lead group; meaning moms lead the discussions, pick the topics and everyone gets a chance to share. I merely serve as the group’s moderator and organizer (I volunteer my time). This is not a breastfeeding clinic and participation in the group cannot take the place of a lactation consultation/assessment. We are happy to lend support, encouragement, and share our knowledge and experiences with you.

Registration is NOT required but it is encouraged so that I have a way to contact you if there are any last minute changes or planned activities; we sometimes plan off-site speakers or demos and we would hate to miss you. I hope you are able to join us.

We are planning our annual Bosom Buddies Halloween Party for Wednesday, October 31st (our 6th one). In the past all the kiddies wear a costume and they could not look more adorable. Bring your camera and a pot luck dish and join us.

You are welcome to join the Breastfeeding Support Group, Bosom Buddies; we try to meet every Wednesday from 11-12:30 pm at the Community Center Room on the first floor of the Colts Neck Library,1 Winthrop Lane, Colts Neck, NJ. When I am not able to attend, the group is moderated by our other mother moderators or they plan off site activities. Here is link for our flyer with the address location, http://www.thelactationlady.com/files/Download/Bosom%20Buddies%20Flyer%202.pdf

The group is free and open to all breastfeeding mothers and babies. This is a mother lead group; meaning moms lead the discussions, pick the topics and everyone gets a chance to share. I merely serve as one of the group’s moderators and organizer (I volunteer my time). This is not a breastfeeding clinic and participation in the group cannot take the place of a lactation consultation/assessment. We are happy to lend support, encouragement, and share our knowledge and experiences with you. Please email me at TheLactationLady@gmail.com if you plan on attending as we sometimes plan guest speakers and off site demo classes.

A mother recounts her own experience and feelings of pressure to breastfeed in today’s NYT (see link below). Obviously, perspective is everything–but the author has a right to her opinion and her desire to express it—although, this piece reads more like a rationalization of the author’s opinions to me.

Many in the field of lactation read blogs, articles, opinion pieces like this and get all riled up and they worry about how the author’s statement will affect other women. I think that everyone is entitled to their opinion and that if there are issues surrounding breastfeeding that we can change–talking about them is the way to go. We should not try to sweep these issues under the carpet, ignore them and pretend they don’t exist or that they do not matter to some women. Instead let’s listen to what women are saying.

One statement the author makes, “unfortunately, there are few places for women to turn for balanced advice on the matter” made me think. Did the author want someone to tell her formula was just as good–her baby would do just fine on formula–that there are no health risks or concerns with formula feeding? Do parents want justification of their decision to formula feed? Do they want to hear half-truths/untruths/lies? The debate is over when it comes to breastfeeding and other forms of infant feeding and parents deserve evidenced based medicine not lies, platitudes, or quoting of out-dated/faulty research–parents deserve the truth so they can be informed consumers. Should health care providers lie or sugar coat information because parents may feel “guilty” or bad (of course, calling formula “evil” like the doctor mentioned in the article is inappropriate). Do smokers want their doctors to tell them that that smoking poses no risk to them–that overweight/obsesity is just fine, since many people are overweight/obese (or perhaps they are overweight/obese–I can’t tell you how many times I have heard of a health care provider that has said to new parents, “I was formula fed and I am just fine” or in one mother’s case,”I was formula fed and look at me–I am a doctor[insert gag here]”)–I could go on and on. Formula is not evil and in cases where mothers cannot breastfeed or choose not to breastfeed it is an acceptable alternative (the WHO does not list formula as the best alternative–expressed milk from mother or donor milk is preferred). Whatever the feeding choice parents make, they deserve respect and support.

I must point out that supporting the choice to breastfeed includes maternity/parental leave and workplace support; the variables that effect breastfeeding outcomes are interdependent not mutually exclusive. Take a look at the article–do you agree or disagree with the points made? How can we support mothers?

I received a video today from a fellow Bosom Buddy of her son nursing. It was so precious, genuine, and simplistic in it’s beauty. It reminded me of this video I came across years ago and had shared with the group way back when.

o Within the first hour of life, holding your baby skin to skin and allowing your infant to latch on his own can help get breastfeeding off to a good start
o When latching and positioning your baby at the breast start by holding your baby close with the baby’s nose close to your nipple
o Stroke the baby’s mouth with your nipple, waiting for them to open their mouth in a wide gape
o When they open wide, guide the baby in towards your nipple, pointing the nipple slightly up towards the top half of the baby’s mouth (with more of the areola, the dark area surrounding the nipple, in the baby’s mouth below, near the chin. More areola will be visible above, near the nose, than below)
o The baby’s chin should be against your breast when latched
o A good latch should feel comfortable with no pain; however, in the beginning it is not uncommon to feel some discomfort when the infant first latches. If there are more than a few moments of discomfort, or if he is suckling only on the nipple, break the suction with your finger, remove the baby, and try again. Several tries may be necessary. The nurse or lactation consultant can help.

2. How often to feed

A new baby needs to nurse at least 8-12 times in 24 hours. To breastfeed successfully, it’s important to nurse whenever the baby is hungry. Usually this works out to a feeding every 1 ½ -3 hours from the start of one feed to the start of the next, but often is erratic and can’t be timed. It’s best not to try to feed at scheduled times. Some babies like to bunch/cluster several feedings into only a few hours, and then may take a longer nap.

3. How to tell when your baby is ready to feed

Follow your baby’s lead; watch and listen for feeding cues:

o Sucking movements of mouth and tongue
o Restlessness or increased body movements, especially hand to mouth movements
o Opening their mouth wide and turning head (rooting)
o Small sounds
o Watch for feeding cues, even if he is asleep
o Crying is a late hunger sign, so try to feed him before he starts to cry

These signs mean the baby is hungry and wants to feed.

4. How long on each side

Leave the baby on the first breast until he will no longer suck and swallow when you massage the breast or stroke his cheek. Then nurse on the other side if he is willing. It’s fine to nurse on just one breast per feeding if your baby is satisfied. Let the baby decide when the feeding is over – he will let go on his own and probably fall asleep. It is good positioning and not limits on the amount of time your baby need to nurse that prevents soreness.

5. How to know when your baby is swallowing

In the beginning your baby should swallow after every few sucks. He’s swallowing if you:

o Hear him swallow (this may be hard to do in the early days of breastfeeding)
o See him swallow
o See or feel his throat move; try placing a finger gently on his throat to see if you feel movement
o See a change in sucking pattern from fast, shallow sucks to longer, deeper sucks where the jaw moves and there is a pause before they take their next suck

6. How to manage engorgement

Many women find their breasts may feel very full, warm, and sore starting on day 2 to 5, within the first week of nursing (while others may notice little change). This is a good sign that your mature milk is coming in, but may leave you temporarily uncomfortable and discouraged. This will pass in 24-48 hours.

o Nurse often, a minimum of 8-12 feedings in 24 hours; don’t skip feedings.
o You may need to soften the nipple and areola to make it easier for your baby to latch
– Place your thumb and fingers on the lighter skin area just behind the areola; the areola is the darker area surrounding the nipple
– Press back toward your chest wall
– Press fingers gently together, keeping them just in back of the areola
– Rotate fingers and repeat
o Apply cold packs between feedings to reduce swelling

7. Breastfeeding without schedules, whenever your baby wants without adding extra foods such as water or formula is important in the first 3-6 weeks

Healthy, full-term babies do not need bottles of water or formula unless there is a medical reason. The first milk, colostrum, is the perfect food for your newborn, and is present in just the right amount. A newborn baby’s stomach is about the size of a marble, growing to the size of a shooter marble by day 3 and a golf ball by day 10 of life. Bottles flow too fast and give the baby too much milk. They may interfere with the baby’s learning to breastfeed and with your milk supply. If your baby needs additional breastmilk or formula for a medical reason, using expressed breastmilk is preferred. Talk to your nurse and lactation consultant about your feeding options; they can also provide special help in getting him back to the breast.

Each time your baby nurses, he “talks” to your body, telling it how hungry he is and how much milk he needs. Your body “listens” and responds hormonally, making the right amount of milk. If schedules or bottles interfere, your body may not get the milk supply right.

Once breastfeeding is well-established, generally between 3 and 6 weeks, an occasional bottle of pumped breastmilk may be introduced without compromising breastfeeding. Every time you breastfeed, milk is removed from the breast, giving your breast a chance to make more milk for the next feeding. If you miss a chance to breastfeed, it is important to remove the milk from your breast using a breast pump, so that your breasts can continue to keep making more milk for the next feedings. The American Academy of Pediatrics (AAP) recommends just breastmilk for the first 6 months for maximum protection against allergies and illnesses.

9. Where to get help if you have problems with breastfeeding after you leave the hospital

Your physician or nurse will give you a list of local resources for breastfeeding support or you can visit the Monmouth /Ocean Breastfeeding Consortium website to find a list of local resources, http://www.njbreastfeeding.org/

10. How to tell if your baby is getting enough milk: The number of wet and soiled diapers can help you determine if your baby is getting enough milk.
o The chart on the last page will be your guide for the first week
o If your baby has at least the number of feedings, the number of wet diapers, and the number of soiled diapers listed on the chart for each day, he is getting enough
o After day 7, your baby should continue to have at least 6 wet diapers and 3 bowel movements every 24 hoursBy the second month, the pattern may change to fewer daily bowel movements

Is the diaper really wet? It may be difficult to tell if a disposable diaper is really wet – putting a clean white tissue in each new diaper will help you know when the baby has urinateCALL YOUR HEALTH CARE PROVIDER IF BABY:

HAS FEWER WET OR SOILED DIAPERS THAN SHOWN ON THE CHART NURSES FEWER THAN 8 TIMES EVERY 24 HOURS SLEEPS MOST OF THE TIME AND IS DIFFICULT TO WAKE UP FOR FEEDINGS

OR IF MOM:
• HAS BREAST ENGORGEMENT WITH FEVER, CHILLS, AND FLU-LIKE SYMPTOMS

“Organic brown rice syrup is often used as a substitute for high fructose corn syrup in prepared organic foods. One of the infant formulas tested contained twice the inorganic arsenic allowed in drinking water, according to Environmental Protection Agency standards. One cereal bar contained 12 times the legal limit for drinking water of 10 parts per billion (ppb). High-energy foods tested had 8 to 17 times the limit.

The researchers tested 17 infant formulas, 29 cereal bars and three types of energy shot drinks. Two infant formulas –- one dairy based and the other soy based – listed organic brown rice syrup as their primary ingredient. They both contained arsenic levels 20 times higher than the other formulas made without organic brown rice syrup.”

I wanted to learn more and see if any formal statements or recalls would ensue, but it appears that rice contamination with arsenic may not be a “new” problem.

For those unfamiliar with the issue, here is a nice synopsis from Natural News, http://www.naturalnews.com/035010_arsenic_baby_formula_brown_rice_syrup.html. How much arsenic is safe (I know–what a DUMB question) but it appears that there are no regulatory limits for food (only water levels) here in the US. Brown rice syrup (a substitute for high fructose corn syrup) is commonly found in “organic” items–can formula be organic? Isn’t the whole idea of formula artificial in nature. I mean no disrespect to those that use formula or use “organic” formula–I am merely pointing out the issue with semantics. The word Formula implies a chemical formulation. When it comes to infant feeding, isn’t the only truly organic option Human Milk?

For now, there does not appear to be any “formal” statements or recommendations regarding the use of this formula. Personally I would reserve using any infant formula with the main ingredient “brown rice syrup” until more information becomes available.

Yesterday, the American Academy of Pediatrics (AAP) reaffirmed their Breastfeeding Policy, Breastfeeding and the use of Human Milk (abstract below), 2012. In 1997 the AAP wrote a strong evidenced based policy on Breastfeeding and strengthened the policy again in 2005; the 2012 update is the newest version. The policy was well received in the field of lactation and by those who are supportive of breastfeeding; although, 15 years has gone and we still face many of the same issues and obstacles in our culture and in our medical community. Where other policies written and adopted by the AAP seem to be considered “gospel” and are strictly adhered to by all in the medical profession, the Breastfeeding Policy is not given the same regard.

Whether it is the high use of supplementation (the lack of support and encouragement for exclusivity), the disregard for evidenced based medicine (i.e.. formula is just as good as breastmilk), or any of the many other issues that still exist–it is the inability to support parents who choose to breastfeed that is our biggest concern. Parents have gotten the message that breast is best – they want to breastfeed, but they need SUPPORT. They need good evidenced based care, encouragement, and someone who is willing to help them overcome any obstacles they face. Unfortunately, many mothers claim one of their biggest obstacles is the health care provider. How can that be? Why?

Health care providers have the opportunity to make such a positive impact on breastfeeding, but all it takes is one phrase or intentional “tone” to derail breastfeeding. For example:

Mom at office says: I don’t think I am making enough milk. My baby is hungry all the time. He eats for 45 minutes and then wants to feed again in an hour. I don’t know what to do.

Health care provider (Dr/Nurse/Midwife, etc): He eats for 45 minutes (said in accusingly tone–not expecting an answer, but letting mom know that 45 minutes is absurd–she must be doing something wrong)? Well that is a lot of feeding, perhaps you should offer formula after each feeding; it sounds like he is still hungry (not only is this advice not evidenced based it is harmful and will likely derail breastfeeding). If he is not hungry he won’t eat the formula (we know babies don’t turn down Thanksgiving Meals and will gladly overeat).

or another example (I really could go on all day):

Mom at office says: I am so tired, I am getting no sleep. My baby nurses all night long.

Health Care Provider: What, they aren’t sleeping through the night (making mom feel like she is doing it wrong)? Most babies at this age sleep……….(fill in whatever you want, but this type of advice was pulled out of you know where).

I have heard it all….the reality is our “opinion” enters into our health care advice far too often. Many times when health care providers talk about breastfeeding our own opinions play far too great of a role. We need to try to stick to the facts but that can be difficult. I can’t tell you how many nurses/docs I have heard tell parents, “Well we were raised on formula and I think we turned out OK.” The use of “we” implying that we are alike and in it together and the “we turned out OK” implying there is nothing wrong with using formula. Statements like that are medically negligent. They go against medical evidence and do not allow parents any informed decision making.

So where do we go from here? I think it is great that the AAP continues to update and publish their Breastfeeding Policy; however, I think most change in perception and our culture will happen as a result of consumer driven change. Parents are smart and savvy. Hopefully they have read the AAP policy on Breastfeeding or books and other information about breastfeeding and when they receive advice that contradicts what the policy or newest information says, they will question it and will search out a health care provider that is supportive of breastfeeding.

Breastfeeding and the Use of Human Milk

SECTION ON BREASTFEEDING

ABSTRACT

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Medical contraindications to breastfeeding are rare. Infant growth should be monitored with the World Health Organization (WHO) Growth Curve Standards to avoid mislabeling infants as underweight or failing to thrive. Hospital routines to encourage and support the initiation and sustaining of exclusive breastfeeding should be based on the American Academy of Pediatrics-endorsed WHO/UNICEF “Ten Steps to Successful Breastfeeding.” National strategies supported by the US Surgeon General’s Call to Action, the Centers for Disease Control and Prevention, and The Joint Commission are involved to facilitate breastfeeding practices in US hospitals and communities. Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad. The “Business Case for Breastfeeding” details how mothers can maintain lactation in the workplace and the benefits to employers who facilitate this practice.

I have spent all my spare time this week trying to organize our family photos. No, I am not taking about the actually hard copies–they still sit in boxes in our basement. They have been there since we moved to our house here in Colts Neck, 5 years ago. That is a project for another day. Instead I have spent all this week trying to organize our digital photos. All the photos we have accumulated since buying our first digital camera when our oldest was about 5 years old–that is almost 10 years of photographs that have been transferred to CDs, USB drives, online storage, from computer to computer sitting there waiting to be enjoyed.

I love my digital camera and my iPhone camera and I although I am not a “photo” person, I have accumulated almost 5000 digital photos (don’t be too impressed this number includes lots of duplicates and photos that need to be deleted)–the big question is what to do with them. I am not a scrapbooker and although I would love to make some albums on Snapfish–let’s face it–I will never get around to it and if I did they would probably end up in those boxes in the basement.

Now, don’t get me wrong–I LOVE looking at photos but there has to be a better way to organize them.

Some suggestions for digital photos:

1) BACK UP and then BACK UP again; always have copies of all your photos/albums (I lost a laptop hard drive once and my biggest concern was the photos; thankfully I could restart the device is safe mode to retrieve all the photos)

2) Look into online storage; this can also serve as your back up

3) Find a way to organize and take the time to do it (I am using Photoshop)

4) A friend suggested making an album a year on sites like Snapfish and I thought this was a nice compromise especially if you have little ones–it forces you to weed through all the photos and pick your favorites

5) Delete those awful photos–you know the ones you would never want anyone to see, the ones with your finger in the view finder, eyes closed, unflattering by anyones standards–let’s face it you will never print them out and they are just taking space.

Do you have any other suggestions? I would love to hear them.

On a parting note, I can’t tell you how much I have enjoyed looking at each and everyone of these photos. The memories each photo brings me is priceless. So although I may not know what to do with my digital photographs or how to keep them organized, I do know that I am going to try to take as many photos of my kids growing up as I can because let’s face it, my memory sucks already so I can’t imagine what it will be like in 20+ years.